Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2022
Primary total knee replacement for tibial plateau fractures in older patients: a systematic review of 197 patients.
Tibial plateau fractures are typically treated with osteosynthesis. In older patients, osteosynthesis is associated with some complications, risk of post-traumatic osteoarthritis and long partial, or non-weight bearing during the recovery phase. To avoid these problems, primary total knee replacement (TKR) has become an increasingly common treatment option. The aim of this study was to evaluate all the relevant literature and summarize the current evidence-based knowledge on the treatment of tibial plateau fractures with primary TKR in older patients. ⋯ Based on low-quality evidence, TKR appears to be a useful treatment option for tibial plateau fractures in older patients. Controlled trials are mandatory to determine the relative superiority of these two options as primary treatment of tibial plateau fractures in older patients.
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Arch Orthop Trauma Surg · Nov 2022
Measuring standing hindfoot alignment: reliability of different approaches in conventional x-ray and cone-beam CT.
Currently there is no consensus how hindfoot alignment (HA) should be assessed in CBCT scans. The aim of this study is to investigate how the reliability is affected by the anatomical structures chosen for the measurement. ⋯ It could be shown that reliability of measuring HA depends on the investigated anatomical structure. Placing a tangent along the calcaneus (2, 3, 5, 6, 7) was shown to be unreliable, whereas determining the weight-bearing heel point (1, 4) appeared to be a reliable approach. The correlation of the measurement workflows is significant (p = 0.036), but too weak (0.272) to be used clinically.
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Arch Orthop Trauma Surg · Nov 2022
Telemedicine visits generate accurate surgical plans across orthopaedic subspecialties.
The role of telemedicine is rapidly evolving across medical specialties and orthopaedics. The utility of telemedicine to identify operative candidates and determine surgical plans has yet to be demonstrated. We sought to assess whether surgical plans proposed following telemedicine visits changed after subsequent in-person interaction across orthopaedic subspecialties. ⋯ Level IV, retrospective cohort study.
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Arch Orthop Trauma Surg · Nov 2022
A practical method for real-time detection of pedicle wall breaching during funneling.
A reliable, real-time method for the detection of pedicle wall breaching during funnelling in spine deformity surgery could be accessible to any surgeon assisted with neuromonitoring. ⋯ III.
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Arch Orthop Trauma Surg · Nov 2022
Preserved periprosthetic bone stock at 5 years post-operatively with uncemented short hip stem in both collared and collarless version.
Previous bone density studies have generally shown bone resorption around both cemented and uncemented total hip arthroplasty (THA) stems. This is presumed to be due to stress shielding. Short stems have been introduced partly to preserve bone in the proximal femur by a more physiological loading of the bone. The purpose of this study was to evaluate bone remodeling around a short, fully hydroxyapatite-coated titanium stem that comes in a collared and collarless version. ⋯ This short stem seems to preserve proximal bone stock up to 5 years, exhibiting similar behaviour both with and without a collar.